If you’re planning to enter a skilled nursing home or assisted living facility, you can either use your own income and assets or you can qualify for Medicaid or Special Assistance. Medicaid and Special Assistance will cover long-term care expenses, unlike Medicare and most health insurance.
While many Americans have Medicare, Medicare only offers temporary assistance to cover up to 100 days in a skilled nursing facility if it is medically necessary. Medicaid, however, does cover long-term care for those who qualify. Special Assistance helps cover the costs of assisted living expenses.
Our attorneys at Brady Cobin Law Group can explain the requirements and asset limits for Medicaid and Special Assistance eligibility in North Carolina. Call us at 919-782-3500 to schedule a consultation.
Asset and Income Limits for Medicaid and Special Assistance in North Carolina
The income limits for Medicaid and Special Assistance are very different. Medicaid only requires that your income be less than the cost of care. Given that the average cost of skilled nursing facilities in North Carolina averages around $8,000 per month, that is rarely a hurdle for most North Carolinians.
Special Assistance, however, has stricter income limits. The gross income limit for a general assisted living resident is $1,355 per month. The gross income limit for a memory care resident is $1,737.
Both Medicaid and Special Assistance have strict asset limits. Both programs have a $2,000 countable asset cap for an individual ($3,000 for a married couple). One major difference between the two programs is Medicaid counts the assets of both spouses, where Special Assistance does not; therefore, the spouse needing assisted living can simply transfer his/her assets to his/her husband or wife.
While Medicaid counts the assets of both spouses, it does have spousal protection in place, called the Community Spouse Resource Allowance. This protection allows the non-institutionalized spouse (the “community spouse”) to keep between $29,724 and $148,620, depending on the couple’s assets at the time skilled nursing is necessary.
Medicaid and Special Assistance consider all sources of income, including paychecks, social security benefits, alimony, and distributions from retirement and investment accounts.
Both programs consider all assets, including bank accounts, investment and retirement accounts, whole life insurance and stocks and bonds; however, the primary residence and one vehicle are examples of two noncountable assets for eligibility purposes.
Qualifying for Medicaid and Special Assistance: The Look Back
North Carolina Medicaid has a five-year lookback period to determine if you have given away assets or transferred assets for less than fair market value. The lookback period for Special Assistance is three years.
Therefore, planning for long-term care early is essential to keep your assets protected for yourself and your family.
Contact an Experienced Medicaid Planning Attorney in Raleigh and Wake Forest, North Carolina.
Medicaid eligibility in North Carolina is complex. Contact us today at Brady Cobin Law Group for help understanding Medicaid planning and eligibility. Call us at 919-782-3500 or contact us online to schedule a consultation.